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Friday, December 8, 2017

Street cleaning causes infections?

I think I can say with some confidence that it is very rare that
cleaning can lead to infections. I am
aware of a study from many moons ago where a facility found that surfaces
cleaned by a particular cleaner were dirtier after cleaning took place. The reason? In order to be more efficient, the
housekeeper would set up their cart the night before, and to minimize waste,
topped up rather than getting fresh disinfectant solution.

I’ve been fortunate enough to have had the opportunity to
travel to some extent, and visit a number of different countries. Along my travels I have noticed that some
areas are dirtier than others. I have
also noted that some areas of the world go so far as to clean their streets
each night to keep the dirt at bay – I happen to know that Bourbon Street in
New Orleans is frequently cleaned…..but dirt is not really the issue
there. In general, I would say that street
cleaning is a good thing. It keeps dirt
at bay, but it also removes food scraps that could become a food source for
insects or rodents. For obvious reasons, cleaning gives a pretty good
impression to those who may be new to a given city. It never occurred to me that street cleaning
could be an infection hazard.

I now fear that street cleaning trucks may become
categorized in the same league as hand dryers for me thanks to a study published in Emerging Infectious Diseases by
researchers from Spain. The study
investigated a case of Legionnaires’ disease that had been confirmed at a
street cleaning company that reported a similar case 4 years prior. The long and the short of it is that
researchers felt that the infections were caused by contaminated water tanks
used by the trucks during street cleaning concluding that Legionella was being
aerosolized through the high-pressure hoses used to clean the streets.

Legionella
loves water, so it’s not necessarily surprising that it would be found in the
street cleaning trucks. During the investigation
the researchers found that the water from the street cleaning trucks was
disposed of each night and refilled the next day with either untreated ground
water or drinking water. The tanks were disinfected once/year for 2hrs with a chlorine-based
solution. However, the foam linings in
the tanks were never replaced and did not dry out overnight creating a perfect
reservoir for Legionella to flourish. As
a result of the investigation, street workers are now required to wear masks
during tasks that could lead to potential exposure. The internal foam pieces
were removed from the trucks and stricter water treatment measures were put in
place.

In the end, cleaning and disinfection is important to
minimize the chance that Legionella can take hold and cause chaos. The upside of studies such as this is that it
shows you just never know where the next reservoir for Legionella or any
pathogen for that matter may be found.
It’s easy to let our guard down during quiet times….but that always
seems to be when the next opportunistic infectious agent crops up and wreaks
havoc! Cleaning saves lives and I guess
as this study shows, effective cleaning and disinfection protocols are needed
everywhere!